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Low risk vaginally born preterm infants: a four year psychological and neurodevelopmental follow-up study
Insights
Preterm infants born before 37 weeks gestation showed developmental delays. Fetal acidosis and gestational age impacted neurodevelopmental outcomes at four years, suggesting later re-evaluation is needed.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Neuroscience
Background:
- Preterm birth (<37 weeks gestation) poses risks for neurodevelopmental outcomes.
- Fetal acidosis at birth is a potential factor influencing infant development.
- Understanding long-term outcomes in low-risk preterm infants is crucial.
Purpose of the Study:
- To assess psychological and neurodevelopmental outcomes at four years in preterm infants.
- To investigate the influence of conceptual age and fetal acidosis on these outcomes.
- To compare outcomes between different gestational age groups and those with/without fetal acidosis.
Main Methods:
- Prospective follow-up study of 39 preterm and 10 term infants.
- Infants categorized by gestational age (29-33 weeks vs. 34-36 weeks) and fetal acidosis (pH <7.20).
- Neurodevelopmental assessments conducted up to four years of age.
Main Results:
- Language performance was delayed in preterm infants, particularly those born between 34-36 weeks.
- Group II (34-36 weeks) infants showed more psychomotor developmental problems.
- Group I (29-33 weeks) infants with fetal acidosis had more frequent neurological handicaps.
Conclusions:
- Gestational age and fetal acidosis significantly influence neurodevelopmental outcomes in preterm infants.
- Developmental trajectories vary based on early-life factors.
- Re-evaluation of neurodevelopmental outcomes at a later age (e.g., six years) is recommended for preterm infants.
Abstract:
A prospective follow-up study of 39 vaginally born low risk preterm (less than 37 weeks of gestation) and ten term control infants was carried out to estimate psychological and neurodevelopmental outcome at four years of age in relation to conceptual age and fetal acidosis at birth. The patients were divided into two groups: infants born after 29-33 weeks gestation (Group I) and those born after 34-36 weeks gestation (Group II), with or without fetal acidosis, i.e. a fetal scalp pH below or above 7.20. Acidotic infants normalized within the first hour after birth. Marked low and high performance groups for intellectual performance and hearing and vision tests were discernable within the first two years. The language performance of preterm infants was delayed compared to infants born at term, especially in Group II infants. At four years of age, a higher number of Group II infants had psychomotor developmental problems; whereas, neurological handicaps were more frequent in Group I infants with fetal acidosis. This indicates that re-evaluation of neurodevelopmental outcome is needed at a later age, e.g. six years of age, in preterm infants after low risk deliveries.